Reliability and sources of variability of 3D kinematics and electromyography measurements to assess newly-acquired gait in toddlers with typical development and unilateral cerebral palsy |
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| Institution: | 1. National Center of Neurorehabilitation for Children « Dr.N.Robanescu », Bucharest, Romania;2. Laboratoire de Traitement de l''Information Médicale, INSERM UMR 1101, Brest, France;3. Université de Bretagne Occidentale, Brest, France;4. Department of Physical and Medical Rehabilitation, CHRU MORVAN, Brest, France;5. Department of Pediatric Physical and Medical Rehabilitation, Fondation ILDYS, Brest, France;6. Murdoch Children’s Research Institute, Melbourne, Australia;7. University of Medicine and Pharmacy « Carol Davila », Bucharest, Romania;1. Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada;2. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada;3. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada;4. C.H. Riddell Movement Assessment Center, Alberta Children’s Hospital, Calgary, Alberta, Canada;5. Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada;6. Section of Pediatric Orthopaedic Surgery, Alberta Children’s Hospital, Calgary, Alberta, Canada;7. Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada;1. Fondation Ildys, Brest, France;2. LATIM, Inserm U1101, Brest, France;3. Université de Bretagne Occidentale, Brest, France;4. Service de Médecine Physique et de Réadaptation, CHRU Brest, France;5. Service de chirurgie infantile, CHRU Brest, France;1. Hugh Williamson Gait Analysis Laboratory, Royal Children’s Hospital, Melbourne, Australia;2. Murdoch Childrens Research Institute, Melbourne, Australia;3. Department of Mechanical Engineering, University of Melbourne, Australia;1. Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy;2. Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy;1. Center of Achievement, California State University, Northridge, CA, United States;2. Kinesiology, University of Virginia, Charlottesville, VA, United States;3. Motion Analysis and Motor Performance Laboratory, Kluge Children''s Rehabilitation Center, Charlottesville, VA, United States |
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| Abstract: | The aim was to 1) determine intersession and intertrial reliability and 2) assess three sources of variability (intersubject, intersession and intertrial) of lower limb kinematic and electromyographic (EMG) variables during gait in toddlers with typical development (TD) and unilateral cerebral palsy (UCP) (age <3 years, independent walking experience ≤6 months). Gait kinematics and surface EMG were recorded in 30 toddlers (19 TD and 11 UCP), during two, 3D-motion capture sessions. Standard error of measurement (SEM) between trials (gait cycles) of the same session and between sessions was calculated to assess reliability. Standard deviations (SD) between subjects, sessions and trials were calculated to estimate sources of variability. Sixty-four percent of kinematic SEM-values were acceptable (2°-5°). Frontal plane measurements were most reliable (SEM 2°-4.6°). In toddlers with UCP, EMG variables were most reliable for affected side, distal muscles. Intrinsic (intertrial and intersubject) variability was high, reflecting both motor immaturity and the high variability of toddler gait patterns. In toddlers with UCP, variability was amplified by motor impairment and delayed motor development. 3D gait analysis and surface EMG are partially reliable tools to study individual gait patterns in toddlers in clinical practice and research, although some variables must be interpreted with caution. |
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| Keywords: | Toddlers 3D motion analysis EMG Reliability Cerebral palsy |
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